BOSTON, Mass. Some books are more important than others. “Aging Well” is one of those books. My personal copy is filled with underlined passages. Exclamation points and check marks line the margins of dozens of pages, as though I was preparing for an hour exam.
From a tiny, book lined office at Brigham and Women’s Hospital, George E. Vaillant, M.D., has been in charge of three rare long-term studies of adult development for much of his professional life. He has been in charge of one, a study of Harvard graduates, since 1966. Another is a study of intellectually gifted women from the Oakland public school system. The third is a study of inner city men. All three studies have followed their subjects with interviews, medical exams, and questionnaires through all of their adult lives and deep into old age.
The goal? To learn how individuals cope, adapt, and develop while determining what factors may contribute to “aging well.”
One immediate message: when it comes to fulfillment as a human being, income is not a good predictor. The income and social status of your parents does little to predict your success in life. Nor does the income you earn as an adult predict your success in life.
Then what affects our ability to find happiness and fulfillment? The answer, it turns out, is best approached in reverse— by finding what destroys happiness and fulfillment.
“Alcohol and tobacco are devastating,” Dr. Vaillant said.
“The surprise is that cholesterol is not important and weight is relatively minor. At 50, weight showed up as a problem but at 70 it just wasn’t important.
“But smoking is more important with each advancing year…
“Alcohol (abuse) is the real sleeper in this because it’s much worse for you than suggested by the epidemiology studies. If you ask people how much they drink they can only account for about 40 percent. With cigarettes it’s near 100 percent…
“Cholesterol is important at 50 but most people don’t die. Alcohol abuse often leads to death. What we find out is that if you pay attention to alcohol abusers, they are the heavy smokers. They die more rapidly. So alcohol is a risk factor for heavy smoking. As a result, many don’t die of alcohol abuse, they die of smoking abuses.”
In the studies, participants were divided into three groups: the “happy-well”, the “sad-sick”, and the prematurely dead. While alcohol abuse and smoking are the fastest way to be among the “sad-sick”— or the prematurely dead— nine other elements can contribute to being among the “happy-well.”
Here are eight of those elements: get regular exercise, avoid being overweight, get an education, marry and love, be future oriented, be thankful and forgiving, empathize with others, and be active with other people. Wealth and income aren’t on the list because they were poor predictors of success as a human being.
The ninth element is the only one that falls clearly in the world of psychiatry: “have mature defenses.”
“You could call them ‘involuntary coping mechanisms’. They are ways we deal with stress that aren’t conscious. They can affect your life,” Dr. Vaillant said.
After pointing out that alcohol abuse usually prevents people from developing mature defenses, Dr. Vaillant tells this story about Beethoven.
“Beethoven, going deaf, is suicidal. He says he’ll kill himself. But he gets completely deaf and writes “Ode to Joy.” He feels better about himself.
“It’s denial (a mature defense)… but he’s a brilliant artist. He writes in the margin of a draft of the score, “that would remind us too much of our despair.”
“He (Beethoven) turns lemons into lemonade.”
Fortunately, it is not necessary to be a Beethoven or Picasso to have ways to transform misfortune or difficulties— to turn lemons into lemonade, as Dr. Vaillant put it. The rest of us can cope, too.
Therein lies the deepest beauty of this book. (Little, Brown, HB, 360 pages, $24.95) Dr. George Vaillant may be a social scientist that extracts data, but he is also a gifted writer— one who communicates even more by telling stories of the lives he has observed with sensitivity and affection.
Money isn’t everything. Indeed, it’s not even on the list of what’s important.
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(c) Scott Burns, 2022